Heinz Endowments grant to give infants a fighting chance

97 babies under the age of 1 died in Allegheny County in 2010

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In a society where the needless loss of just one young life is considered a tragedy worthy of tears and television coverage, here's a statistic: Ninety-seven babies under the age of 1 died in Allegheny County in 2010.

That statistic alone is enough to keep advocates like Wilford Payne up at night. But as the director of several health clinics serving poor areas in Pittsburgh and beyond, he knows an even more troubling statistic: Black babies are more than twice as likely to die than white babies, a racial divide no one has yet been able to conquer.

"I live it every day," he said.

A new grant from the Heinz Endowments hopes to turn things around. This year, the charitable trust will donate nearly $250,000 to the Allegheny County Health Department to combat infant deaths, buttressing an effort to circle the wagons around needy mothers and offer help they might otherwise never find.

The money will go to the department's Maternal and Child Health Program, which is already pursing an initiative to lower mortality rates by looking at all aspects of an expectant mother's life, not just the report from her latest checkup.

As Heinz Endowments senior program officer Carmen Anderson describes it, getting women to the doctor is just the first step.

"That has been the gold standard for a long time -- but we still have these persistent disparities," she said. "I think this approach goes deeper into trying to identify the root case and then connecting people from that point."

For instance, she said, if the mother had a drug problem, the initiative could connect her with treatment services. If there's an environmental or social problem, the mother could be referred to a Department of Human Services program.

Pittsburgh has long stood out as an aberration in early childhood deaths. In 2010, the infant mortality rate in Allegheny County was 7.5 deaths per 1,000 live births, health department statistics show. The rate nationwide was 6.147, according to the U.S. Centers for Disease Control and Prevention. Pennsylvania pulled in at 7.25.

Among the black population in Pittsburgh, the mortality rate hit 14.5 in 2010, two-and-a-half times the rate for whites, which was just 5.7.

While the numbers are stark, the reason why is less clear. Patricia Documet is the scientific director of the University of Pittsburgh's Center for Health Equity, which has studied the racial implications of infant mortality. Poor parents have fewer resources to spend on their children, and transportation to the doctor's office may be harder to come by, she said.

But she notes that even black mothers with advanced degrees are more likely to lose their child than their white colleagues are, moving the question beyond simple socioeconomics. She's read research that theorizes racism may hold more of a role than expected, although intangible.

"Racism creates stress and shows us a worse health outcome, and more stress causes earlier deliveries," she said.

Still, she adds, the cause for the spike in Pittsburgh remains elusive. "I don't know why in Pittsburgh this is worse. I don't think it is the worst. But it is pretty bad."

Mr. Payne, the health center director, warns that looking just at year-by-year percentages can be misleading, as statistics are skewed by the relatively low number of babies who die before reaching their first birthday. A few more deaths make a big spike in the charts.

His concerns are more practical, such as making sure expectant parents show up to prenatal exams. Nearly a third of his patients skip out on appointments, he said.

"We have people who think a pill will take care of anything," he said. "We have to get people to understand how important it is to keep their health care appointments and follow up."

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